Organization
LEISURE WORLD OF MARYLAND, CORP.
Active
Other names
Leisure World Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA BRONAUGH (ADMINISTRATOR)
(301) 598-1550
Entity
Organization
Contact information
Practice address
3305 N LEISURE WORLD BLVD, SILVER SPRING, MD 20906-1367
(301) 598-1590
(301) 598-1569
Mailing address
3305 N LEISURE WORLD BLVD, SILVER SPRING, MD 20906-1367
(301) 598-1590
(301) 598-1569
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B773
BLUECROSS/BLUE SHIELD
—
01
—
CA5483
RAILROAD MEDICARE
—
Enumeration date
06/30/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up